India has enormous distinguished advantages in the field of pharmaceuticals particularly in the production and distribution of quality generic drugs at affordable prices to the world. At home, various stakeholders like pharmaceutical industry, various governmental agencies, as well as doctors are doing their bits to ensure availability of quality medicines at affordable prices to all.

Background: Corneal grafting is associated inherent risks that could result in permanent loss of vision and significantly affect the quality of life. Corneal collagen cross linking is a new technique that can either prevent corneal transplantation or delay the progress of keratoconus. Advanced tools of the day can measure the contours of the cornea perfectly to adopt the new technology of corneal collagen cross linking. Objective: To evaluate the outcome of the collagen cross linkage using riboflavin 0.1% and ultraviolet A radiation of wavelength 370 nm. Methods: This prospective interventional trial of corneal collagen cross-linking was carried out in 50 eyes of 30 patients with progressive keratoconus from January 2013 to July 2014. The paired t test was used to check the significance of the difference between 2 dependent groups. The level of statistical significance was set at P<0.05 Results: 80% of the study subjects in the age group of 16 to 25 years. 60% of the study group was males. 34% of the study group was with severing keratoconus. Based on pachymetry findings, 84% of the study group classified as moderate keratoconus. Conclusion: Visual acuity improved in keratoconus patients by 1.5 lines of Snellen's equivalent, henceforth CXL can be treatment modality for visual improvement along with other techniques.

Background: In view of the rising incidents of domestic fatalities, a detailed study was undertaken focusing on different causes and manners of injuries and deaths occurring within the house and its surroundings. During this study, thorough medical and technical investigations were considered. Ultimately public education and their awareness are important for its prevention. Objectives: The present study is made to analyze pattern of different domestic accident deaths in regard to Age and Sex distribution, Residence, Place of Occurrence in the Home Method of inflicting injuries Methods: The materials considered in the study are the police reports like FIR, crime Scene, Panchayatdar statement, Hospital deaths summary, Inquest report, and doctors' reports, in addition to engineering technical reports. The postmortem study of 100 dead bodies of domestic accidents was carried with analytical data during January 2004 to May 2007 at Gandhi Hospital Mortuary Secunderabad. Common variables were spot deaths against Hospital deaths, deaths in different age groups, literacy status of the victims, socioeconomic status, and marital status with urban slum and rural variation in addition to sex criterion as basic parameter. Result: The results of the study showed that, the victims were more in categories of male, old aged, illiterates, low socio economic, unmarried laborers and living in urban slums. The major causes of deaths were due to injuries commonly occurring in the kitchen. Spot deaths were more than Hospital deaths. Conclusion: The results obtained in the present study regarding various observations in the domestic accidents were consistent with the other studies reported at national and international levels.

Background: Thrombocytopenia is defined as a platelet count below 150 x 10⁹ / liter in adults, caused by accelerated platelet destruction or decreased production. It is classified as mild [platelet counts 100 – 150 x 109/ liter], moderate [platelet counts 50 – 100 x 10⁹ / L] and severe [platelet counts less than 50 x 10⁹ / L] Objective: The aim was to determine the incidence of severe thrombocytopenia in the maternal near miss cases and study the outcome and characteristics of these mothers with thrombocytopenia, with and without hypertension. Methods: An audit of cases that were diagnosed to be maternal near miss from January 2011 to December 2014 was undertaken at Fernandez Hospital, which is a private tertiary referral perinatal center with 8000 deliveries annually. WHO criteria [2009] were applied for defining maternal near miss morbidity. The incidence of severe thrombocytopenia [platelet count less than 50,000 per cu mm] was assessed, and the patients were divided into two groups based on the presence or absence of hypertension. The etiology of thrombocytopenia and outcomes [MNM morbidity indicators] and maternal deaths were studied. Results: During the study period we had 263 maternal near miss cases in 28,836 deliveries giving an incidence of 9/1000 live births. Severe thrombocytopenia [platelet counts < 50,000 per cu mm] was present in 103 mothers. Out of these cases of severe thrombocytopenia hypertension was present in 47 mothers and 56 mothers were normotensive. The study group of thrombocytopenia with hypertension had less incidence of postpartum hemorrhage [17% versus 23%] but with higher morbidity in the form of need for ventilation not related to anesthesia [34% versus 28%] and similar transfusion needs, and higher incidence of acute kidney injury and jaundice. Perinatal deaths and maternal deaths were higher in the hypertension group. Conclusion: In mothers with thrombocytopenia and maternal near miss, hypertension is a predictor of adverse fetal outcomes but not of adverse maternal outcomes.

Introduction: Foramen Tympanicum or Huschke is an aperture in tympanic plate of temporal bone. It may persists after age of five years in small population .If it persists mostly it is asymptomatic but few percentage of population go in for complications like ear infections ,parotid fistula and temporo mandibular joint infection. Study of these foramina is clinically useful for ENT surgeons, general surgeons and dento maxillary facial surgery. Aim: Due to its clinical importance during ENT and Dento-Maxillary Facial surgeries study of incidence of Foramen Tympanicum is undertaken. Material & Methods: 100 skulls from Malla Reddy Institute of Medical Sciences, Malla Reddy women?s Medical College, Osmania Medical College and Kakatiya Medical College, Warangal were studied. Sex of skulls determined as per the standard parameters given in Grays Anatomy text book. Distance from the lower margin of external acoustic meatus to the foramen Tympanicum was measured using a scale among the male and female skulls. Results: Out of 100 skulls, 69 were male & 31 were female skulls. Out of 69 male skulls foramen Tympanicum was found in three skulls. Among them two were unilateral and in one it is bilateral; in the female skulls no foramen Tympanicum was found.

Back ground: Skeletal tuberculosis could lead to disabling and painful states of bones and joints affecting the quality of life. Objective: To study the clinico-social profiles of Skeletal Tuberculosis (SKTb) in Karimnagar district of Telangana state Methods: A hospital based cross-sectional study was carried out using purposive sampling. Three doctors collected the data from 100 patients suffering from SKTb using a pretested questionnaire on the social variables, clinical presentations and probable indicators and analyzed. Group talks were conducted with patients for imparting necessary heath knowledge regarding prevention of further complications. Results: Overall prevalence of SKTb was about 33%. SKTb was more seen among males (58%). Tuberculosis of Spine was the leading bone disease (52%) followed by that of knee (22%) and hip (16%). Mean age affected was 45-65 years (39%).SKTb affected largely lower and middle class people (90%), less educated people (92%) non-executives (92%) Majority of patients (62%) were tuberculin positive .One third of patients (33%) had past history of pulmonary tuberculosis. Thirty percent of patients gave family history of tuberculosis. Conclusion: SKTb was found to be related with the past history of pulmonary tuberculosis, family history, and tuberculin positivity. Intensifying health education about these probable indicators is worth trying among the patients' families and people at risk to prevent SKTb.

Background: An organization is as strong and successful as its employees are. By measuring employee satisfaction in key areas, organizations can gain the information needed to improve their satisfaction, motivation, retention and productivity. Objective: To assess the factors leading to job satisfaction among health care workers at Taluka Shahapur in district Thane in state of Maharashtra. Methods: Four Focus group discussions were planned for 50 health care workers in Block Shahapur in district of Thane. Participation was on voluntary basis conducted during 5-10-2010 to 8-10-2010. 35 ANMs and 20 MPWs participated in four focus group discussions. Result: 70% respondents were satisfied with their job. 80% respondents felt that their services are appreciated and acknowledged by the community73% respondents are not satisfied with their pay scale. 94% respondents are suspicious about the transparency of the system. Low monetary compensation, overburden of work due to vacancies, poorly defined job roles, poor non monetary rewards for achievements, poor participation in micro planning and decision making were mentioned as major stressors by most of the participants. Conclusion: The study, however, is yielding a useful conclusion that some organizational transformation must be initiated at district and national level. To improve health care services in India, policy-makers need to consider the impact of current policies on job satisfaction in order to improve the efficiency of the system. Constant appraisal programs and appreciation should be instilled in the health care system to reinstate and motivate the employees.

Background: Sexually transmitted infections are a major health problem affecting women, a study conducted by National AIDS control Organization (NACO) estimated Andhra Pradesh to be having the highest percentage of individuals (22.8%) affected with HIV among those attending STI clinics, so the study conducted to know the prevalence of Sexually transmitted infections among women of reproductive age in the community. Objective: The objective of the study was to assess the prevalence of sexually transmitted infections among women of reproductive age through a syndromic approach and the various socio demographic factors associated. Materials and methods: community based cross- sectional study conducted in urban slums of Guntur city. A pre tested questionnaire was administered for information regarding socio- demographic profile and symptoms of sexually transmitted infections. Women who had symptoms of sexually transmitted infections as per the syndromic approach were examined clinically, treated and referred to government general hospital for further follow-up. Results: 520 women participated in the study. The prevalence of sexually transmitted infections in the total sample was 32.69% (n-170 of 520). The prevalence of vaginal discharge syndrome was 27.88 % (n-145of 520), genital ulcer syndrome was 1.34 %( n-7), and pain lower abdomen was 3.46 %( n-18).The prevalence of symptoms in women with STI was – 156 (91.76%, n-170) had vaginal discharge. 18(10.58%) had pain lower abdomen. 4 (2.35%) had lymphadenopathy, 4(2.35%) had burning micturition, 2(1.17%) had dyspareunia and 18(10.58%) had backache. The prevalence of STIs by clinical diagnosis on per speculum examination of the 170 women were – Bacterial vaginoses- 98(57.65%), Trichomonas vaginalis- 28(16.47%), Candidiasis- 18 (10.59%), cervicitis with PID- 9(5.29%), Herpes- 5(2.94%), syphilis- 2(1.18%) and Venereal warts- 1(0.59%). Conclusion: The prevalence of RTI/STI on the basis of self- reporting and clinical examination was 32.69%. The most common symptom was vaginal discharge 91.76%. The most common infection was bacterial vaginosis 57.65%. The younger age groups, 15- 19yrs- 53.84%were the most affected followed by the age group 20- 34yrs-33.8%. The infections were more common in women working as agriculture labor 50.55%, illiterate women 40.97%, and women of low social status,-Scheduled tribe- 63.64% & scheduled caste – 40.96%.

Background: Cervical cancer becomes the second leading cancer in Malaysia and HPV infection is the main cause of this cancer. The availability of HPV vaccination can reduce down the risk of getting HPV infection thus will also reduce incidence of cervical cancer. However, due to little current information pertaining to the nature of HPV infection, cervical cancer and HPV vaccination themselves among the risky age, which is secondary school girls, therefore, a thorough understanding about knowledge on HPV, cervical cancer and HPV vaccination of secondary school girls and their practice on HPV vaccination is needed. Objective: The aim of this study is to investigate the knowledge of secondary school girls about human papillomavirus (HPV), cervical cancer and human papillomavirus (HPV) vaccination and their practices on HPV vaccination. Methods: A cross sectional study was conducted in two secondary schools; SMK TengkuPanglimaPerang and SMK (P) Methodist, Kuantan, Pahang, Malaysia. The total numbers of 295 secondary school girls were studied, and the data were collected through the distribution of structured questionnaires. Data analysis involved descriptive statistic and chi square test by using SPSS version 20. Results: Results revealed that there was a high level of knowledge about HPV, cervical cancer, and HPV vaccination, however low/poor practice on HPV vaccination among secondary school girls. Conclusion: Therefore, it is suggested that further study is required to focus the gap between knowledge, and practice, and examines the reasons of not receiving HPV vaccinations in the targeted group. Strategies for enhancing awareness to take HPV vaccination are also needed.

Tuberculosis is the world's leading cause of death from a single infectious agent and is caused by mycobacterium tuberculosis. Central nervous system tuberculosis is most serious complication of tuberculosis in children. Central nervous system tuberculosis in children presents commonly as tubercular meningitis, post-tubercular meningitis hydrocephalus, and much more rarely as space occupying lesions known as tuberculomas. Compression of spinal cord can result in paralysis, and the extent of which depends on the level and area of cord involvement. Tuberculosis of dorsal or dorsolumbar spine causes paraplegia which is the presenting feature of TB spine and incidence is 16-35% and it is rare without spine involvement. Incidence of paraparesis is about 0.9% which is rare and it occurs at a later stage of the disease. Here we report a case of 3yrs old male child with tubercular meningitis who initially presented with transient paraparesis.

Extramedullary plasmacytoma is a rare soft tissue neoplasm characterized by monoclonal proliferation of plasma cells. We report a case of extramedullary plasmacytoma in a 45 year old male patient with a history of nasal obstruction and a polypoid mass was noticed in the Left Maxillary sinus. The mass was completely excised and histopathology, immuno-histochemistry findings lead to a diagnosis of Plasmacytoma of Left Maxillary Sinus